Anterior repair, also known as anterior vaginal wall repair or cystocele repair, is a surgical procedure aimed at correcting a condition called cystocele. A cystocele occurs when the supportive tissues between a woman’s bladder and vaginal wall weaken, causing the bladder to bulge into the vagina. This can lead to discomfort, urinary issues, and pelvic organ prolapse. Anterior repair surgery helps restore the anatomy and strength of the vaginal wall, alleviating symptoms and improving the patient’s quality of life.

Reasons for Anterior Repair: Anterior repair surgery is recommended for women who experience the following symptoms and conditions:

  1. Cystocele: A cystocele is a common condition where the bladder drops into the front wall of the vagina due to weakened pelvic floor muscles and connective tissues. This can result in urinary problems, such as difficulty emptying the bladder completely or urinary incontinence (leakage).
  2. Pelvic Organ Prolapse: Anterior repair may be performed as part of a comprehensive treatment plan for pelvic organ prolapse, a condition in which one or more pelvic organs (bladder, uterus, or rectum) descend into the vaginal canal.
  3. Recurrent Urinary Tract Infections (UTIs): Cystoceles can lead to incomplete bladder emptying, increasing the risk of UTIs. Anterior repair can help improve bladder function and reduce the frequency of infections.

Preparing for Anterior Repair Surgery: Before undergoing anterior repair surgery, your healthcare provider will take the following steps:

  1. Medical Evaluation: Your doctor will review your medical history and conduct a physical examination, including a pelvic exam, to assess the extent of the cystocele and determine if surgery is the appropriate treatment.
  2. Preoperative Instructions: You may be asked to refrain from eating or drinking for a specific period before the surgery. Your doctor will provide detailed preoperative instructions to follow.
  3. Medication Review: Inform your doctor about any medications you are currently taking, including over-the-counter drugs and supplements, as some may need to be temporarily stopped before the procedure.
  4. Anesthesia Options: You will discuss the type of anesthesia to be used during the surgery (general anesthesia or regional anesthesia) and address any concerns or questions you may have.

The Anterior Repair Procedure: Anterior repair surgery is typically performed in a hospital or surgical center and involves the following steps:

  1. Anesthesia: You will be given anesthesia to ensure you are comfortable and pain-free during the procedure.
  2. Incision: The surgeon will make an incision in the vaginal wall to access the weakened tissues and the underlying bladder.
  3. Tissue Repair: The surgeon will carefully repair and strengthen the supportive tissues between the bladder and vaginal wall. Sutures may be used to reinforce the area and restore the anatomical position of the bladder.
  4. Incision Closure: The incision in the vaginal wall will be closed with dissolvable stitches.

Recovery and Postoperative Care: After anterior repair surgery, you can expect the following:

  1. Hospital Stay: Most patients can go home on the same day as the surgery, while some may require an overnight hospital stay.
  2. Pain Management: Your doctor will provide pain medications to manage any discomfort during the initial recovery period.
  3. Activity Restrictions: You will need to avoid strenuous activities, heavy lifting, and sexual intercourse for the recommended recovery period, usually a few weeks.
  4. Follow-up Appointments: Regular follow-up appointments will be scheduled to monitor your healing progress and address any concerns.
  5. Pelvic Floor Exercises: Your healthcare provider may recommend pelvic floor exercises (Kegel exercises) to help strengthen the pelvic muscles and support the repair.

Potential Risks and Complications: As with any surgical procedure, anterior repair surgery carries certain risks, including but not limited to:

Your surgeon will discuss these risks with you before the surgery and take measures to minimize the likelihood of complications.

Conclusion: Anterior repair is a surgical procedure that can effectively treat cystocele and related urinary issues, restoring comfort and functionality to the pelvic area. If you are experiencing symptoms of pelvic organ prolapse or cystocele, consult with a qualified healthcare professional to discuss your options, including the possibility of anterior repair surgery.